The moderating role of affect in associations between urgency and alcohol outcomes among heavy drinking men-who-have-sex with men (MSM)

Negative and positive urgency (NU; PU) are associated with increased drinking and related consequences, which may be especially consequential among MSM due to alcohol-related HIV risk. This is believed to occur because individuals high in NU/PU react more impulsively when experiencing intense affective states. This study examined how individual differences in positive and negative affect (PA/NA) may moderate urgency-alcohol associations among heavy-drinking MSM. In this cross-sectional survey, a national sample of heavy-drinking MSM recruited online (N = 185) completed measures of alcohol use, urgency, and affect. Negative binomial regressions assessed whether NA and PA moderated the associations between urgency components and alcohol outcomes. For drinks-per-week, there was a significant NUxNA interaction (IRR = 1.02, 95%CI = [1.00,1.03]), with NU predicting drinks-per-week most strongly for high-NA participants. For heavy drinking episodes (HDEs), there was a significant PUxPA interaction (IRR = 0.98, 95%CI = [0.956,0.998]), with PU predicting HDE frequency most strongly for low-PA participants. The NUxNA interaction was not significant for HDEs (IRR = 1.02, 95%CI = [1.00,1.04], p = 0.07) or consequences (IRR = 1.00, 95%CI = [0.99,1.02], p = 0.48), and PUxPA was not significant for drinks-per-week (IRR = 1.00, 95% CI = [0.98,1.01], p = 0.63) or consequences (IRR = 1.00, 95%CI = [0.98,1.01], p = 0.78). Participants with higher past-month NA and lower PA showed stronger associations between urgency components and specific alcohol consumption outcomes. Results suggest that individual differences in NA and PA may moderate the associations between NU and PU and alcohol outcomes in distinct ways.